These rules and regulations are adopted under the authority
of MGL c. 111, § 31.
The purpose of these regulations is to protect public health
by establishing minimum conditions governing the practice of body
art in the Town of Avon.
As used in these regulations, the following terms shall have
the meanings indicated:
AFTERCARE
Written instructions given to the client, specific to the
body art procedure(s) rendered, about caring for the body art and
surrounding area. These instructions will include information about
when to seek medical treatment, if necessary.
BODY ART
The practice of physical body adornment by permitted establishments
and practitioners using, but not limited to, the following techniques:
body piercing, tattooing, cosmetic tattooing, branding, and scarification.
This definition does not include practices that are considered medical
procedures by the Board of Registration in Medicine in the commonwealth,
such as implants under the skin, which shall not be performed in a
body art establishment.
BODY ART ESTABLISHMENT or ESTABLISHMENT
A specified place or premises that have been granted a permit
by the Board, whether public or private, where the practices of body
art are performed, whether or not for profit.
BODY ART PRACTITIONER or PRACTITIONER
A specified person who has been granted a permit by the Board
to perform body art in a body art establishment that has been granted
a valid permit by the Board.
BODY PIERCING
Puncturing or penetration of the skin of a person with presterilized
single-use needles and the insertion of presterilized jewelry or other
adornment thereto in the opening. This definition includes piercing
of the outer perimeter of the ear, but does not include piecing of
the earlobe with presterilized single-use stud-and-clasp ear-piercing
systems.
BRAIDING
Cutting of strips of skin of a person, which strips are then
to be intertwined with one another and placed onto a person so as
to cause of allow the incised and interwoven strips of skin to heal
in such an intertwined condition.
BRANDING
Inducing a pattern of scar tissue by use of a heated material
(usually metal) to the skin, making a serious burn, which eventually
becomes a scar.
CLIENT
Any person who has requested a body art procedure at a body
art establishment.
CONTAMINATED WASTE
Any liquid or semi-liquid blood or other potentially infectious
materials; contaminated items that would release blood or other potentially
infectious materials in a liquid or semi-liquid state if compressed;
items that are caked with dried blood or other potentially infectious
materials and are capable of releasing these materials during handling;
sharps and any wastes containing blood and other potentially infectious
materials, as defined in 29 CFR Part 1910.1030 (latest edition), known
as "Occupational Exposure to Bloodborne Pathogens" or as defined as
"infectious or physically dangerous medical or biological waste" in
accordance with 105 CMR 480.000, Storage and Disposal of Infectious
or Physically Dangerous Medical or Biological Waste, State Sanitary
Code, Chapter VIII and the Town of Avon's local regulations concerning
infectious and hazardous waste.
DEPARTMENT
The Massachusetts Department of Public Health.
DISINFECTANT
A product registered as a disinfectant by the United States
Environmental Protection Agency.
DISINFECTION
The destruction of disease-causing microorganisms on inanimate
objects or surfaces, thereby rendering these objects safe for use
or handling.
EAR PIERCING
The puncturing of the lobe of the ear with a presterilized
single-use stud-and-clasp ear-piercing system following manufacturer's
instructions.
EQUIPMENT
All machinery, including fixtures, containers, vessels, tools,
devices, implements, furniture, display and storage areas, sinks,
and all other apparatus and appurtenances used in connection with
the operation of a body art establishment.
HAND SINK
A lavatory equipped with hot and cold running water under
pressure, used solely for washing hands, arms or other portions of
the body.
HOT WATER
Water that attains and maintains a temperature 110° F.
to 130° F.
INSTRUMENTS USED FOR BODY ART
Hand pieces, needles, needle bars, and other instruments
that may come in contact with a client's body or may be exposed to
bodily fluids during body art procedures.
INVASIVE
Entry into the client's body either by incision or insertion
of any instruments into or through the skin or mucosa, or by any other
means intended to puncture, break, or otherwise compromise the skin
or mucosa.
JEWELRY
Any personal ornament inserted into a newly pierced area,
which must be made of surgical-implant-grade stainless steel; solid
14k or 18k white or yellow gold, niobium, titanium, or platinum; or
a dense, low-porosity plastic, which is free of nicks, scratches,
or irregular surfaces and has been properly sterilized prior to use.
MINOR
Any person under the age of 18 years.
OPERATOR
Any person who alone, jointly or severally with others owns,
has care, charge, or control of any body art establishment as agent
or lessee of the owner or as an independent contractor, but is not
a body art practitioner.
PERMIT
Approval in writing by the Board to either (1) operate a
body art establishment or (2) operate as a body art practitioner within
a body art establishment. Board approval shall be granted solely for
the practice of body art pursuant to these regulations. Said permit
is exclusive of the establishment's compliance with other licensing
or permitting requirements that may exist the Board's jurisdiction.
PERSON
An individual, any form of business or social organization
or any other nongovernmental legal entity, including but not limited
to corporations, partnerships, limited-liability companies, associations,
trusts or unincorporated organizations.
PHYSICIAN
An individual registered by the Board of Registration in
Medicine pursuant to MGL c. 112, § 2.
PROCEDURE SURFACE
Any surface of an inanimate object that contacts the client's
unclothed body during a body art procedure, skin preparation of the
area adjacent to and including the body art procedure, or any associated
work area which may require sanitizing.
SANITARY
Clean and free of agents of infection or disease.
SANITIZED
Effective disinfectant treatment by a process using intermediate
disinfectants for enough time to reduce the bacteria count, including
pathogens, to a safe level on semi-critical or noncritical equipment.
SANITIZING PROCEDURE
A process of reducing the numbers of microorganisms on cleaned
surfaces and equipment to a safe level as judged by public health
standards and which has been approved by the Department.
SCARIFICATION
Altering skin texture by cutting the skin and controlling
the body's healing process in order to produce wounds, which result
in permanently raised wheals or bumps known as "keloids."
SHARPS
Any objects (sterile or contaminated) that may purposefully
or accidentally cut or penetrate the skin or mucosa, including, but
not limited to, needle devices, lancets, scalpel blades, razor blades,
and broken glass.
SHARPS CONTAINER
A puncture-resistant, leakproof container that can be closed
for handling, storage, transportation, and disposal and that is labeled
with the International Biohazard Symbol.
SINGLE-USE
Products or items that are intended for one-time, one-person
use and are disposed of after use on each client, including, but not
limited to, cotton swabs or balls, tissues or paper products, paper
or plastic cups, gauze and sanitary coverings, razors, piercing needles,
scalpel blades, stencils, ink cups, and protective gloves.
STERILIZE
The use of a physical or chemical procedure to destroy all
microbial life, including highly resistant bacterial endospores.
TATTOO
The indelible mark, figure or decorative design introduced
by insertion of dyes or pigments into or under the subcutaneous portion
of the skin.
TATTOOING
Any method of placing ink or other pigment into or under
the skin or mucosa by the aid of needles or other instruments used
to puncture the skin, resulting in permanent coloration of the skin
or mucosa. This term includes all forms of cosmetic tattooing.
UNIVERSAL PRECAUTIONS
A set of guidelines and controls, published by the Centers
for Disease Control and Prevention (CDC), as "Guidelines for Prevention
of Transmission of Human Immunodeficiency Virus and Hepatitis B Virus
to Health-Care and Public-Safety Workers" in Morbidity and Mortality
Weekly Report (MMWR), June 23, 1989, Vol. 38, No. S-6, and as "Recommendations
for Preventing Transmission of Human Immunodeficiency Virus and Hepatitis
B Virus to Patients During Exposure-Prone Invasive Procedures" in
MMWR, July 12, 1991, Vol. 40, No. RR-8. This method of infection control
requires the employer and the employee to assume that all human blood
and specified human body fluids are infectious for HIV, HBV, and other
blood pathogens. Precautions include hand washing; gloving; personal
protective equipment; injury prevention; and proper handling and disposal
of needles, other sharp instruments, and blood and body fluid-contaminated
products.
Unless otherwise ordered or approved by the Board, each body
art establishment shall be constructed, operated and maintained to
meet the following minimum requirements:
A. Physical plant.
(1)
All walls, floors, ceilings, and procedure surfaces within the
body art establishment shall be smooth, free of open holes or cracks,
light-colored, washable, and in good repair. Walls, floors, and ceilings
shall be maintained in a clean condition. All procedure surfaces,
including client chairs/benches, shall be of such construction as
to be easily cleaned and sanitized after each client.
(2)
All body art establishments shall be completely separated by
solid partitions or by walls extending from floor to ceiling, from
any room used for human habitation, any food establishment or room
where food is prepared, any hair salon, any retail sales, or any other
such activity that may cause potential contamination of work surfaces.
(3)
Effective measures shall be taken by the body art operator to
protect against entrance into the establishment and against the breeding
or presence on the premises of insects, vermin, and rodents. Insects,
vermin, and rodents shall not be present in any part of the establishment
or adjacent structure.
(4)
There shall be a minimum of 80 square feet of floor space for
each practitioner in the establishment. Each establishment shall have
an area that may be screened from public view for clients requesting
privacy. Multiple body art stations shall be separated by dividers,
curtains, or partitions, at a minimum.
(5)
The establishment shall be well-ventilated and provided with
an artificial light source equivalent to at least 20 footcandles three
feet off the floor, except that at least 100 footcandles shall be
provided at the level where the body art procedure is being performed,
and where instruments and sharps are assembled.
(6)
A separate, readily accessible hand sink with hot and cold running
water, equipped with wrist- or foot-operated controls and supplied
with liquid soap, and disposable paper towels shall be readily accessible
within the body art establishment. One hand sink shall serve no more
than one practitioner. Hand sinks must be installed according to the
local plumbing code. A separate mop sink must be provided for clean
up of the establishment.
(7)
In addition to any service sinks, there should be a minimum
of one lavatory sink and one working toilet in a body art establishment.
(8)
At least one covered waste receptacle shall be provided in each
operator area and each toilet room. Receptacles in the operator area
shall be emptied daily, and solid waste shall be removed from the
premises at least weekly. All refuse containers shall be lidded, cleanable,
and kept clean.
(9)
All instruments and supplies shall be stored in clean, dry,
and covered containers.
(10)
Practitioners who use ear-piercing systems must conform to the
manufacturers' directions for use and applicable United States Food
and Drug Administration requirements.
(11)
Reusable cloth items shall be mechanically washed with detergent
and sterilized after each use. The cloth items shall be stored in
a dry, clean environment until used.
(12)
No animals of any kind shall be allowed in a body art establishment,
except service animals used by persons with disabilities (e.g., Seeing
Eye dogs). Fish aquariums shall be allowed in waiting rooms and nonprocedural
areas.
B. Information to be kept on file. The following information shall be
kept on file on the premises of a body art establishment and available
for inspection by the Board:
(1)
Employee information:
(a)
Full names and exact duties.
(e)
Identification photos of all body art practitioners.
(2)
Establishment information.
(c)
Owner's name and address.
(3)
A complete description of all body art procedures performed.
(4)
An inventory of all instruments and body jewelry, all sharps,
and all inks used for any and all body art procedures, including names
of manufacturers and serial or lot numbers, if applicable. Invoices
or orders shall satisfy this requirement.
(5)
Current contract of contaminated waste hauler.
(6)
A copy of these regulations.
C. It shall be unlawful for any person to perform body art procedures
unless such procedures are performed in a body art establishment with
a current permit.
D. Each body art practitioner must be a minimum of 18 years of age.
E. Each practitioner shall perform all body art procedures in accordance
with Universal Precautions set forth by the United States Centers
for Disease Control and Prevention.
F. Jewelry is any personal ornament inserted into a newly pierced area,
which must be made of surgical-implant-grade stainless steel; solid
14k or 18k white or yellow gold, niobium, titanium, or platinum; or
a dense, low-porosity plastic, which is free of nicks, scratches,
or irregular surfaces and has been properly sterilized prior to use.
G. Smoking, eating, or drinking is prohibited in the area where body
art is performed.
H. Operators/practitioners shall refuse service to any person who, in
the opinion of the operator/practitioner, is under the influence of
alcohol or drugs.
I. The practitioner shall maintain a high degree of personal cleanliness,
conform to hygienic practices, and wear clean clothes when performing
body art procedures. Before performing body art procedures, the practitioner
must thoroughly wash his/her hands in hot running water with liquid
soap, then rinse hands and dry with disposable paper towel. This shall
be done as often as necessary to remove contaminants.
J. In performing body art procedures, the practitioner shall wear disposable
single-use nonlatex gloves. Gloves must be changed if they become
contaminated by contact with any unclean surfaces or objects or by
contact with a third person. The gloves shall be discarded, at a minimum,
after the completion of each procedure on an individual client, and
hands shall be washed before the next set of gloves is donned. Under
no circumstances shall a single pair of gloves be used on more than
one person. The use of disposable single-use gloves does not preclude
or substitute for hand-washing procedures as part of a good personnel
hygiene program.
K. If, while performing a body art procedure, the practitioner's glove is pierced, torn, or otherwise contaminated, the procedure delineated in Subsection
I shall be repeated immediately. The contaminated gloves shall be immediately discarded, and the hands washed thoroughly (see Subsection
I above) before a fresh pair of gloves is applied. Any item or instrument used for body art that is contaminated during the procedure shall be discarded and replaced immediately with a new disposable item or a new sterilized instrument or item before the procedure resumes.
L. Contaminated waste, as defined in this code, that may release liquid
blood or body fluids when compressed or may release dried blood or
body fluids when handled must be placed in an approved "red" bag marked
with the International Biohazard Symbol. It must then be disposed
in accordance with 105 CMR 480.00, Storage and Disposal of Infectious
or Physically Dangerous Medical or Biological Waste, State Sanitary
Code, Chapter VIII, or, at a minimum, in compliance with 29 CFR Part
1910.1030, Occupational Exposure to Bloodborne Pathogens. Used sharps
ready for disposal shall be disposed of in approved sharps containers.
Contaminated waste that does not release liquid blood or body fluids
when compressed or does not release dried blood or body fluids when
handled may be placed in a covered receptacle and disposed of through
normal, approved disposal methods. Storage of contaminated waste on
site shall not exceed 30 days, as specified in 29 CFR Part 1910.1030.
M. No practitioner shall perform any body art procedure upon a client
under the age of 18 years without the presence, written consent, and
proper identification of a parent, legal custodial parent, or legal
guardian. Nothing in this section shall require a practitioner to
perform any body art procedure on a person under 18 years of age regardless
of parental or guardian consent.
N. Any skin or mucosa surface to receive a body art procedure shall
be free of rash or any visible infection.
O. The skin of the practitioner shall be free of rash or infection.
No person or operator affected with boils, infected wounds, open sores,
abrasions, weeping dermatological lesions or acute respiratory infection
shall work in any area of a body art establishment in any capacity
in which there is a likelihood that the person could contaminate body
art equipment, supplies, or working surfaces with body substances
or pathogenic organisms.
P. Proof shall be provided, upon request of the Board, that all practitioners
have either completed or were offered and declined, in writing, the
hepatitis B vaccination series. This offering shall be included as
a pre-employment requirement.
A written report of any injury, infection complication or disease
to a client as a result of a body art procedure, or complaint of injury,
infection complication or disease, shall be forwarded by the operator
or practitioner to the Board of Health which issued the permit and
to the Massachusetts Department of Public Health, with a copy to the
complainant or injured client within five working days of its occurrence
or knowledge thereof. The report shall include:
A. The name of the affected client;
B. The name and location of the body art establishment involved;
C. The nature of the injury, infection complication or disease;
D. The name and address of the affected client's health care provider,
if any;
E. Any other information considered relevant to the situation.
The body art establishment shall keep a record of all persons
who have had body art procedures performed. The record shall include
the name, date of birth, and address of the client, the date of the
procedure, the name of the practitioner who performed the procedure(s),
type and location of procedure performed, and signature of client,
and, if the client is a minor, proof of parental or guardian presence
and consent. Such records shall be retained for a minimum of three
years and shall be available to the Board upon request. The Board
and the body art establishment shall keep such records confidential.
Body art establishments shall submit a scale drawing and floor
plan of the proposed establishment for a plan review by the Board,
as part of the permit application process.
A. Establishment permit.
(1)
No person, firm, partnership, joint venture, association, business,
trust, corporation or organized group of persons may operate a body
art establishment except with a body art establishment permit from
the Board. No license or permit shall be issued until after a public
hearing has been held by the Board, which shall be based on the satisfaction
that said use is appropriate, and that it will not create a nuisance,
or is not dangerous to the public health.
(2)
Any person operating a body art establishment shall obtain an
annual permit from the Board. The Board shall set a reasonable fee
for such permit.
(3)
A permit for a body art establishment shall not be transferable
from one place or person to another.
(4)
A valid body art establishment permit shall be posted in a prominent
and conspicuous area where clients may readily observe it.
(5)
The holder of a body art establishment permit must hire only
practitioners who have complied with the practitioner permit requirements
of this code.
(6)
All permits expire on December 31 of the year issued, unless
revoked sooner by the Board of Health.
B. Body art practitioner permit.
(1)
No person shall practice body art procedures without first obtaining
a practitioner permit from the Board. The Board shall set a reasonable
fee for such permits.
(2)
The practitioner permit expires on December 31 of the year issued
unless revoked sooner by the Board of Health.
(3)
Application for a practitioner permit shall include:
(f)
Place(s) of employment as a practitioner;
(g)
Training and/or experience:
[1] Evidence satisfactory to the Board of at least
two years' actual experience in the practice of performing body art
activities of the kind for which the applicant seeks a body art practitioner
permit to perform, whether such experience was obtained within or
outside of the commonwealth;
[2] Evidence of a minimum twelve-month completed apprenticeship
program as approved by the Board, with instruction in the kind of
body art for which the applicant seeks a body art permit to perform;
(h)
Proof of attendance and a passing grade (C or better) at a bloodborne
pathogen training program (or equivalent) given or approved by the
Board of Health.
[1] The applicant shall provide documentation of attendance
and passing (C or better) of courses approved by the Board, on the
following subjects:
[a] Anatomy I and II and Physiology I and II.
[b] Skin diseases, disorders and conditions (including
diabetes).
[c] Infectious disease control, including waste disposal,
hand-washing techniques, sterilization equipment operation and methods,
and sanitation/disinfection/sterilization methods and techniques.
[2] Examples of courses approved by the Board include
courses such as: "Preventing Disease Transmission" (American Red Cross)
and "Bloodborne Pathogen Training" (U.S. OSHA). Training/courses provided
by professional body art organizations or associations or by equipment
manufacturers may also be submitted to the Board for approval.
C. No permit shall be issued unless, following reasonable investigation
by the Board, the body art establishment or practitioner has demonstrated
compliance with the provisions of this section and all other provisions
of these regulations.
D. All permits shall be conditional upon continued compliance with the
provisions of this section as well as all applicable provisions of
these regulations.
E. All permits shall be posted in a prominent and conspicuous area where
clients may readily observe them.
The Board may summarily suspend a permit pending a final hearing
on the merits on the question of revocation if, based on the evidence
before it, the Board determines that an establishment and/or a practitioner
is an immediate and serious threat to the public health, safety or
welfare. The suspension of a permit shall take effect immediately
upon written notice of such suspension by the Board.
The Board shall refer to the appropriate District Attorney,
the Attorney General, or other appropriate law enforcement agency
any incidents of unauthorized practice of body art that come to its
attention.
If any rule or provision contained herein is found to be unconstitutional
or invalid by a court of competent jurisdiction, the validity of the
remaining rules and provisions will not be so affected.
These regulations are adopted by a vote of the Avon Board of
Health at the meeting on December 16, 2010. The effective date is
January 1, 2011.